NEW FIGURES from the Ministry of Health indicate that enrollment to the community health insurance scheme, Mutuelle de Santé, had fallen below the 2007 levels – of 75 per cent – to 73 per cent.

While these figures are still impressive on the global scale, something must have gone wrong along the way ever since subscription peaked in 2010 when it hit an all time high of 91 per cent.

Yet, from then on, it has been a constant downward spiral. What could be the cause? Has the Ministry of Health become complacent with the exceptional achievements in the health sector and shifted attention elsewhere?

A review of the health scheme conducted by the Senate last year had discovered that the government had accumulated over Rwf2.3 billion in arrears owed to district hospitals and over Rwf400 million to national referral hospitals and health centres.

Even though the debt owed to district hospitals has been cleared with the government promising to clear the balance this financial year, the backlog of payments is a clear indication that there was a disconnect along the way.

Stakeholders need to go back on the drawing board to determine what went wrong; why are health insurance subscriptions going down?

The answer might be found in the approaches local governments are using to bring on board those lagging behind, but whatever the reason, something needs to be done to reverse this downward trend.